Background and aim: Cutaneous leishmaniasis is a common disease in the world and is an endemic disease in Iran. Highly variable results of systemic treatment of cutaneous leishmaniasis with levamisole have been reported in literature so far. The purpose of this study was to evaluate the efficacy and tolerability of levamisole as an adjuvant therapy with Intralesional Glucantime.Materials and methods: Sixty patients with cutaneous leishmaniasis were included in this clinical trial.The patients were divided randomly in two groups. Thirty patients in group 1 received Intralesional Glucantime along with placebo (vitamin B complex tablets, 1 tablet every 8 hours for 2 successive days per week) and 30 patients in group 2 received Intralesional Glucantime plus levamisole 150 mg tablet every 8 hours in two successive days per week in adults and 3-5 mg/kg for children under 30 kg for 6 weeks.Results: The clinical response of combination therapy (78%) was significantly better then group 1 (64%), the difference was statistically significant (p<0.001). The difference in rate of re-epithelization between the two groups was also statistically significant (p<0.01).Conclusion: This study demonstrated that levamisole can be used as an adjuvant therapy in combination with Intralesional Glucantime for the treatment of cutaneous leishmaniasis.

Background: Currently, Glucantime is considered the first-line treatment of cutaneous Leishmaniasis. This study aimed to evaluation of Intralesional Glucantime (IG) and Cryotherapy (Cryo) plus Intralesional Glucantime (Cryo and IG) therapeutic efficacy on Zoonotic Cutaneous Leishmaniasis in Qom province, Iran. Materials and Methods: In this randomized controlled trial of 197 CL patients reported from Qom health centers, Iran during (2014-2017), 112 cases were entered to this study. According to the Iranian Ministry of Health therapeutic guide line of CL, 54 cases with 116 lesions received IG weekly, and 58 patients with 115 lesions received the IG once a week coupled with Cryo using liquid nitrogen once every two weeks. The average volume of injected solution per lesion was 0. 2 ml to 0. 5 ml into the border of the healthy skin and the onset of erythema in the lesions using insulin syringe needles. In second therapeutic method; cryotherapy with liquid nitrogen was performed by dipstick technique. At first, the lesion size and induration of lesions were recorded. After 7 and 12 weeks of treatment lesions healing rate was monitored. Healing was defined as complete re-epithelialization and disappearance of induration. Results: Out of 112 CL patients, 54 cases with 116 lesions received IG, and 58 patients with 115 lesions received Cryo and IG. At 7th week after the initiation of treatment, complete healing was observed in 56 out of 116 lesions (48. 1%) in the group which received weekly IG and 83 out of 115 lesions (72. 2%) in the group which received biweekly Cryo plus IG. At 12th week after the treatment, the cure rate was 91% and 100% in group which received weekly IG and group which received IG once a week coupled with cryotherapy (p=0. 001). Conclusion: Based on the findings, IG once a week coupled with cryotherapy was more effective compared with weekly IG and reduced the period of treatment.

Introduction: Cutaneous leishmaniasis is a parasitic disease caused by various Leishmaniasis species and can result in a disfiguring scar. Hence, effective treatment is mandatory for prevention of the disease sequellae. The goal of this study was assessment and comparison of Intralesional Glucantime plus steroid with Intralesional Glucantime in the treatment of cutaneous leishmaniasis.Methods: In this clinical trial study, 62 patients with cutaneous leishmaniasis were divided randomly into 2 groups. 32 cases were treated with Glucantime pluse steroid while other 30 received only Glucantime. In Glucantime plus steroid group, 0.5 cc/cm2 Glucantime (48.5 mgr) plus 0.1 cc/cm2 Triamcinolone Acetonide (4 mgr) were injected intradermally, whereas in the other group, Glucantime (48.5 mgr) was injected intradermally. Six courses of injection were applied weekly. After fulfilling treatment, the lesions were evaluated for size, erythema and indurations. Data was analyzed by t-test and differences were considered significant with P<0.05.Results: Clinical improvement mean scores were 5.6 (62%) and 5.2 (57%) after 6 weeks in the Glucantime plus steroid and Glucantime alone groups, respectively. The difference was not statistically significant. More satisfactory results and higher scores were noted in lesions with less than 4 months duration in comparison with lesions of longer than 4 months in Glucantime plus steroid group.Conclusion: Both treatment modalities are not considerably different in total, but in lesions with less than 4 months duration, the difference is noticeable, obvious which might be the consequence of diminished edema, erythema and induration following steroid therapy.

Background: In spite of different methods of treatment, there is not a simple, safe and complete curative treatment for cutaneous leishmaniasis (CL), yet. Objective: To compare the efficacy of Intralesional Glucantime injection alone, with the combined triple therapy of cryotherapy, paramomycm ointment and Intralesional Glucantime in the treatment of CL. Patients & Methods: 157 patients with CL were randomly allocated into two groups, 81 patients in group I were injected with Intralesional Glucantime (twice a week up to healing of the lesions or maximum 6 weeks). 76 patients in group 2 were treated with paramomycin ointment (15% in 10% urea, twice a day), cryotherapy (maximum 3 times 2 weeks apart and injection of Intralesional Glucantime (once a week), for the same period as group 1. Results: After 6 weeks, complete cure rate in group 2 (89.5%) was significantly more than group 1 (70.4%) (P<0.05). Conclusion: Our results indicating of more efficacy of the triple therapy is in accordance with the previous studies of combined cryotherapy and paramomycin. It could be recommended as a better treatment modality for CL wherever possible.      

Background & Objective: Cutaneous leishmaniasis is endemic in Iran and there are different systemic and local treatments for this disease. There is continuous investigation for finding the most efficient and economical method with little side effects for the treatment of cutaneous leishemaniasis. For this purpose we performed a comparative study between Intralesional Glucantime injection and cryotherapy in the treatment of papular cutaneous leishmaniasis.Materials & Methods: In this clinical trial 47 patients with papular cutaneous leishmaniasis refered to dermatology clinic of Ghaem hospital in Mashhad were assayed. All patients had positive direct smears. They divided randomly in two groups. First group treated by weekly Intralesional Glucantime injection and second group treated by weekly cryotherapy. The length of therapy for two groups was 5 weeks. Two groups were followed for 1.5 months after the last week of the treatment.Results: Thirty eight patients completed the study, 21 patients with 35 lesions and 17 patients with 36 lesions were treated by interalesional injection of Glucantime and cryotherapy respectively. Clinically in interalesional Glucantime group 37.1% of lesions and in cryotherapy group 22.2% of lesions completely cured.The difference between two groups was not statistically significant using chi-square test.Conclusion: Cryotherapy in comparison with interalesional Glucantime injection is equally effective and also is cheaper with little side effect.

Background: Systemic or Intralesional injection of Glucantime in treatment of cutaneous leishmaniasis, sometimes leads to a local allergic reaction. This study aimed to evaluate the effect of local allergic reaction to Intralesional Glucantime on recovery course of cutaneous leishmaniasis. Methods: In a retrospective cross-sectional study, the data of patient records of cases with cutaneous leishmaniasis, who underwent local treatment with Glucantime in Imam Reza dermatology clinic, Mashhad, Iran, from March 2006 to March 2011, were evaluated. All cases that showed a localized allergic reaction to Glucantime were selected as the case group and the cases of cutaneous leishmaniasis without any allergic reaction to treatment were selected as control group. Patients were evaluated in subsequent follow-up periods for improvement after Glucantime injection. Findings: The mean number of injections needed for complete recovery was 6. 54± 3. 76 in patients with topical allergic reaction and 9. 77 ± 5. 14 in control group; there was a statistically significant difference between two groups (P = 0. 002). The time to complete recovery in patients with topical allergic reaction to Glucantime was insignificantly shorter. Conclusion: This study showed that patients with local allergic reaction to Glucantime require fewer numbers of injections to achieve complete recovery than non-allergic patients.

Background: Leishmaniasis is endemic in Iran, and Mashhad is one of the most involved cities. Glucantime, prescribed as Intralesional or systemic injection, is the most common treatment for cutaneous leishmaniasis. We investigated the additive effect of topical ciprofloxacin on the Intralesional injection of Glucantime in treatment of cutaneous leishmaniasis. Methods: This randomized clinical trial study was performed on patients with cutaneous leishmaniasis diagnosed by direct smear or biopsy, who referred to Imam Reza and Ghaem teaching hospitals of Mashhad University of Medical Sciences. Patients were randomly allocated into two groups to receive either topical liposomal ciprofloxacin 2% twice daily plus weekly Intralesional Glucantime or Intralesional Glucantime alone, for eight weeks. The size of induration and the rate of healing was assessed every week. Findings: There were no significant differences between the groups in cure rate (decrease in induration size equal or more than 75%) (P = 0. 410) and the time of healing (P = 0. 050) 45 days after the end of treatment. Conclusion: Using topical ciprofloxacin does not have any additive effect on the conventional treatment of cutaneous leishmaniasis.

Background: Cutaneous leishmaniasis (CL) is a parasitic disease caused by leishmania species. An ideal treatment for CL has not found yet. Objectives: cryotherapy To evaluate the efficacy of alone and combined with Intralesional Glucantime injection in the treatment of papulonodular CL. Patients & Methods: 300 patients with CL were randomly assigned to two treatment groups in this dinicyl trial. In group 1, 100 patients with 149 lesions were treated with cryotherapy plus Intralesional Glucantime injection every 2 weeks. In group 2, 200 patients with 230 lesions were treated only with cryotherapy, every 2 weeks. Both groups were followed for 6 months after last treatment. Results: Clinical and parasitological cure were seen in 90% of cases in group 1 and 57.3% in group 2 (P<0.05). Conclusion: Combination of cryotherapy and Intralesional Glucantime injection is an effective treatment modality in early lesions of CL.